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random shit i be finding hard > anotha one > Flashcards

anotha one Flashcards

1
Q

what mode of inheritance is gilberts

A

autosomal recessive

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2
Q

meaning of penetrance

A

likelihood of someone with a specific genes to express the phenotype ie me and my brother both have ADHD genes but he actually has ADHD - 50% penetrance

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3
Q

inotropic

A

contraction of muscles

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4
Q

chronotropic

A

change in HR

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5
Q

dromotropic

A

conduction speed

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6
Q

what valves are open/closed in inflow phase

A

mitral and tricuspid valves are open - blood flows through atria to ventricles

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7
Q

what happens when ventricular pressures exceeds atrial pressure

A

AV valves snap shut (S1)

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8
Q

what happens in isovolumetric contraction

A

ventricular systole - contracting of ventricles to raise pressure

no valves are opening

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9
Q

what happens in outflow

A

pressure in ventricles exceeds aorta/pulmonary artery

so semilunar valves open

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10
Q

isovolumetric relaxation

A

ventricles relax and pressure in aorta/pul artery exceeds again

no valves open

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11
Q

cardiac myocyte > myofribrils > sarcomeres

what makes up a sarcomere

A

thick and thin filaments

thick - myosin

thin - 3 types of protein

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12
Q

thin filaments

A

actin
tropomyosin
troponin complexes - C I T

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13
Q

troponin I

A

inhibition of actin and myosin binding

by breaking down ATP

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14
Q

troponin T

A

structural connection to tropomyosin

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15
Q

troponin C

A

calcium binding site

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16
Q

what results in a contraction

A

when actin and myosin bind together

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17
Q

what happens when calcium ions binds to troponin C

A

causes a conformation change in troponin complex and exposes binding sites to myosin can bind to actin > contraction

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18
Q

cardiac action potential duration

A

200ms - 400ms

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19
Q

elastic arteries

A

contain more elastin than muscular arteries (which contain external and internal elastic lamina)

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20
Q

what cells are found in crypts of leiberkuhn

A

enterocytes - absorbe nutrients

enteroendocrine cells - eg I cells secrete CCK

paneth cells - lysosomal enzymes

goblet cells - secrete mucous to promote movement

dendritic cells - mediate food antigen tolerance

peyers’ patches - lymph nodules, low cuboidal M cells

proliferating stem cells - line the wall of crypts

brunners glands - alkaline mucosa - neutralise chyme

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21
Q

what is intrinsic factor

A

binds to B12
a glycoprotein secreted by parietal cells

pernicious anaemia

IgG

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22
Q

where are peyers patches only found

A

ileum

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23
Q

how does glucose and galactose enter enterocytes

A

(SGLT-1) co-transport with sodium - active transport

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24
Q

how does fructose enter enterocytes

A

GLUT5 - facilitated diffusion

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25
Q

exocrine pancreas secretions receptors

A

M1/M3 (Ach)

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26
Q

hydrolysis of triglycerides via

A

pancreatic lipase

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27
Q

absorption of lipids/triglycerides in the small intestine

A
  1. trigs need to be emulsified by bile salts

hydrophobic part buries into trig, while hydrophilic part stays sticking out on the membrane - breaking up the trig

  1. pancreatic lipases (which are water soluble) hydrolyses the trig into a monosaccharide 2 fatty acids
  2. it becomes a micelle - which can be absorbed by epithelial cells > enterocytes
  3. golgi/RER/SER make it a trig again, drains into lymph, goes into lacteal and here a chylomicron will come get it and take it into circulation
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28
Q

cranial nerves responsible for saliva release

A

facial VII and glossopharyngeal IX

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29
Q

dry mouth constipation fluid retention confusion is due to what drug

A

anticholinergics - Ipratroprium

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30
Q

MoA inhaled corticosteroids

A

up regulation of anti-inflammatory genes and downregulation of pro-inflammatory genes ie TNFa

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31
Q

MoA ipratropium

A

bronchodilation - smooth muscle relaxation

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32
Q

what asthmatic tx causes candidiasis

A

inhaled glucorticoids

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33
Q

MoA montelukast

A

competes for receptor cytseinyl leukotriene receptor 1 - E4 D4

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34
Q

MoA theophylline

A

phosphodiesterase inhibitor

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35
Q

what counters the effects of theophylline

A

activated charcoal

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36
Q

what is the law of la place

A

smaller sphere > more intense surface tension > greater tendency to collapse

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37
Q

what does surfactant do

A

reduce alveolar surface tension, reduce collapsing pressure and increase lung compliance

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38
Q

define lung compliance

A

change in volume that the lungs achieve per unit change in pressure ie emphyema reduces compliance

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39
Q

dorsal respiratory group

A

frequency of inspiration

basic rhythm of inspiration

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40
Q

apneuistic centre

A

sleep breathing

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41
Q

respiratory control centres

A

medulla and pons

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42
Q

medullary resp centre :

A

dorsal - inspiratory

ventral - expiratory

DIVE

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43
Q

pneumotaxic centre

A

inhibits respiration / resets

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44
Q

cerebral cortex

A

allows for voluntary breathing ie hyperventilating

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45
Q

what is the forced vital capacity

A

air that can be maximally expired after a maximal inhalation

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46
Q

type 2 chronic resp. failure oxygen goal

A

88-92%

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47
Q

what do central chemoreceptors respond to

A

H+ ions - acidic

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48
Q

Fick’s Law of diffusion

A

rate of diffusion = (alveolar area x diffusion constant x difference in partial pressure) / thickness of alveolar membrane

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49
Q

what would increase rate of diffusion of gas from alveoli to blood

A

thick alveolar membrane

50
Q

where are S cells located

A

jejunum and duodenum

51
Q

function of S cells

A

secrete secretin which is aq bicarbonate - neutralises stomach acid ie is responsive to low pH in the duodenum

52
Q

D cell secretion

A

somatostatin

53
Q

I cell secretion

A

CCK

54
Q

what cells does omeprazole work on

A

parietal cells

secrete HCl acid via H+/K+ ATPase pump

55
Q

chief cells

A

secrete proteases - pepsinogen and chymosin

breaks down proteins

56
Q

enterochromaffin cells

A

histamine - histamine promotes acid secretion

57
Q

G cells

A

secrete gastrin

58
Q

what does enterokinase do ?

A

trypsinogen > trypsin

59
Q

enterogastric reflex

A

signal = chyme in the SMALL intestine - inhibits gastric secretion

60
Q

MoA orlistat

A

-inhibits the hydrolysis of triglycerides - a pancreatic lipase inhibitor

therefore can cause steatorrhea

weight loss medication

61
Q

what are the 3 gastric glands

A

cardiac - cardia
pyloric - pylorus
and gastric - fundus

62
Q

which 2 gastric glands are histologically the same

A

gastric and pyloric - contain mostly surface mucous cells

63
Q

gastric glands

A

contain :

parietal cells 
chief cells 
mucous neck cells 
enteroendocrine cells 
stem cells
64
Q

what are gastric pits

A

invaginations in the gastric surface epithelium , they connect to gastric glands and allow glandular products to be secreted

65
Q

when is exocrine pancreas secretion at its highest

A

intestinal phase e

66
Q

MoA metaclopramide

A

dopamine antagonist

promotes gastric emptying - relaxation of the LOS

stops nausea and vomitting - is a anti-semitic

67
Q

pressure gradient that drives pulmonary blood flow in upright lung base

A

arterial pressure is greater than venous pressure

68
Q

primary vasoactive substance that regulates pulmonary vascular resistance

A

oxygen

69
Q

perfusion pressure in zone 1 lung

A

PA > Pa > Pv

results in alveolar dead space as alveolar pressure exerts itself on the capillaries - compressing them - reducing blood flow

*dead space = alveoli are ventilate but not perfused

70
Q

perfusion in lung zone 2

A

Pa > PA > Pv

Pa is greater here due to the effects of gravity - Pa > PA drives pulmonary blood flow

71
Q

lung bases - zone 3

A

Pa > Pv > PA

highest pulmonary blood flow here

72
Q

is lobar pneumonia a type 1 resp failure

A

yes

73
Q

pathophysiology of chronic bronchitis

A

chronic exposure to smoke or air pollutants leading to mucus hyper secretion in the bronchi

74
Q

pathophysiology of interstitial lung disease

A

irreversible scarring of pulmonary connective tissue due to chronic inflammation

75
Q

abnormal irreversible enlargement of the alveoli due to alveolar wall destruction

A

emphysema

76
Q

most common bacteria - community acquired

A

streptococcus pneumonia

77
Q

nerve damaged most likely to cause respiratory failure

A

phrenic nerve

78
Q

guillane barre syndrome

A

autoimmune neuropathy

79
Q

glycopeptides

A

eg = vancomycin, bleomycin

bacterial cell wall - mode of action

80
Q

sulphonamide + trimethoprim

A

co - trimoxazole

via folate

81
Q

penicillin MoA

A

inhibits peptidoglycan cell wall by preventing the cross-linking by binding to transpeptidase

82
Q

protein synthesis antibiotics

A

tetracycline - these ones form complexes with other ions

aminoglycosides

macrolides

83
Q

cephalosporins

A

ie ceftriaxone

works well against gram - bacteria
can pass the blood brain barrier

84
Q

fluoroquinolone

A

eg ciprofloxacin

inhibits the p450 liver enzymes

they inhibits DNA gyrase - bactericidal

85
Q

amino glycoside

A

ie gentamicin

can cause ototoxicity

protein synthesis inhibitor

86
Q

treatment of TB

A

RIPE

rifampicin - orange wee
Isoniazide
Pyrazinamide
Ethambutol

2 months of RIPE
4 months of RI

87
Q

mantoux test +

A

TB

88
Q

widespread downsloping ST segments can be caused by what drug

A

digoxin

89
Q

sinus bradycardia 1stTx

A

IV atropine

90
Q

beck’s triad

A

pericardial tamponade :

muffled heart sounds

low bp

Raised JVP

91
Q

what is beck’s triad associated with

A

cardiac tamponade

92
Q

how to treat cardiac tamponade

A

pericardiocentesis if haem. unstable

93
Q

Tx acute pericarditis

A

NSAIDS + colchicine

  1. corticosteroids
  2. abx / pericardiocentesis
94
Q

atrial flutter

A

P waves irregularly irregular

sawtooth / flutter baseline

95
Q

homelessness

A

TB

96
Q

infective endocarditis signs + main inv

A 
tricuspid valve 
splinter haemorrhage 
staph. aureus , strep viridans
poor dentition
osler nodes
janeway lesions 
roth spots

3 cultures at 3 different times/sites > then trans thoracic echo

97
Q

what hepatitis has a high associated with hepatocellular cancer

A

B

must screen using alpha-fetoprotein

98
Q

carcinoid syndrome

A

carcinoid tumour broken down systemically into circulation causing flushing and wheeze as a GI symptom

urinary 51AA - investigation

99
Q

campylobacter jejuni

A

Guillaine Barre

Milk

100
Q

wilsons

A

caeruloplasmin

101
Q

haemochromatosis

A

ferritin

102
Q

acute/severe UC tx

A

IV corticosteroids

103
Q

erythema nodosum

A

mainly crohns

104
Q

beading of bile ducts / onion skinning

A

primary sclerosis cholangitis

105
Q

infections that seem like IBDs

A

whippleis

giardiasis

bacterial overgrowth

> > would need to do a stool microscopy

106
Q

65-year-old lady who has recently been diagnosed with polycythaemia rubra vera, is admitted to the Emergency Department with sudden onset abdominal pain and swelling. On examination, she had a tender, palpable liver, with moderate abdominal distension and shifting dullness. What is the most likely diagnosis?

A

budd chiara - hepatic vein thrombosis

107
Q

tx for watery diarrhoea + shigella

A

ciprofloxacin + iv fluids

108
Q

if curb65 <2

A

manage patient at home with antibiotics for 7days

and sort appointment soon

109
Q

swinging fever

A

empyema

110
Q

chlamydophila psitacci

A

bird - pneumonia

111
Q

pulmonary fibrosis investigation

A

high-resolution CT

112
Q

what type of pneumonia would show hyponatreamia

A

legionella

113
Q

TB - where ?

A

geographically - india most common

anatomically - upper/middle lungs

114
Q

BNP +

A

pulmonary hypertension

115
Q

type 2 resp. failure when:
PCO2 >6 PO2 <8
how do we manage

A

non-invasive ventilation

116
Q

type of pleural effusion likely due to HF

A

transudate

ie protein <25g/L

117
Q

protein 35g/L

A

indicates infection

118
Q

gram negative coccobacilli associated with COPD

A

haemophilus influenza

119
Q

hospital acquired bacteria (most common ones)

A

pseudomonas aerginosa
staph aureus
enteroabacteria

120
Q

klebsiella

A

red currant jelly

alcoholics

121
Q

mycoplasma pneumonia

A

joint pain-y pneumonia

younger patients

122
Q

pneumocystis pneumonia

A

HIV

random shit i be finding hard (8 decks)

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